Arthroscopic treatment of a one-fourth anteroinferior glenoid comminuted fracture-dislocation with concomitant three-part complex proximal humerus fracture in a middle-aged man: a case report

Abstract

Introduction

Proximal humeral fracture-dislocations can occur in high-energy traumas. This injury can be accompanied by a glenoid fracture; however, it is a rare type of complex injury in patients aged under 60 years.

Materials and methods

A 53-year-old man presented with a three-part fracture-dislocation of the proximal humerus and a severely comminuted glenoid fracture. For the glenohumeral dislocation and proximal humeral fracture, we performed closed reduction using a threaded Steinman pin and fixation with percutaneous cannulated screws. Using arthroscopy, while maintaining humeral traction with the Steinman pin, the intra-articular glenoid fragments were reduced and then fixed with a buttressing headless screw and one suture anchor. After a 6-week immobilization with a shoulder spica cast, rehabilitation was initiated.

Results

We confirmed bony union of the fracture sites after 6 months post-surgery. The patient showed excellent clinical outcomes with a nearly full range of motion without instability

Conclusions

We reported a successful outcome for a complex proximal humeral fracture involving the glenoid using closed reduction and fixation for the proximal humeral fracture and arthroscopic reduction and fixation for the comminuted anteroinferior glenoid fracture.

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Correspondence to Hyoung-Sik Kim.

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Jin-Chul Oh, Hyoung-Sik Kim, Gi-Hoon Lee, and Ho-Jung Kang declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Yonsei University Gangnam Severance Hospital, reference number 3-2019-0158) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Oh, JC., Kim, HS., Lee, GH. et al. Arthroscopic treatment of a one-fourth anteroinferior glenoid comminuted fracture-dislocation with concomitant three-part complex proximal humerus fracture in a middle-aged man: a case report. Arch Orthop Trauma Surg 140, 1901–1907 (2020). https://doi.org/10.1007/s00402-020-03402-w

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Keywords

  • Proximal humerus fracture
  • Glenoid fracture
  • Anterior shoulder dislocation
  • Arthroscopy
  • Screw fixation